Dealing with Ostomy Supply Costs in Canada

Unlike some other countries, where ostomy supplies are provided for free or at a very low-cost, Canadians usually have to pay out-of-pocket. This can lead to financial stress and anxiety, but there are several strategies that I’ve found to help keep costs to a minimum.

Disclaimer: While I have done my best to make sure that the information provided is accurate and up-to-date, things change, so always check with specific programs to be certain of the eligibility criteria and coverage amounts.

PharmaCare covers ostomy supplies for patients who have undergone surgery on the bowel and/or bladder that results in a colostomy, ileostomy or urostomy. Actual coverage is subject to the rules of the patient’s PharmaCare plan, including any deductible requirements.

To be eligible you must be covered by one of the following PharmaCare plans:

Those who qualify for a drug card under The 65Plus Plan also qualify for the Ostomy Subsidy Program. The program will reimburse for 75% of the retail cost of benefit ostomy items. The beneficiary is responsible for the remaining costs. The beneficiary is required to purchase the ostomy supplies and submit their original prescription receipts.

How to apply: No application is necessary. A Prescription Drug Program card is automatically issued when the Department of Health and Community Services is notified by Service Canada that an individual is in receipt of the Guaranteed Income Supplement (GIS) and Old Age Security benefits (OAS).

Any resident of Ontario with a valid Ontario Health card issued in their name, who has a colostomy, ileostomy, fecal continent reservoir, urostomy, ileal conduit or urinary continent reservoir. The ostomy must be permanent, or temporary if required for at least six months.

As of April 2016:

If you have one ostomy, you are eligible to receive $787.50 per year.

If you have two ostomies, for example, a colostomy and a urostomy, you will receive $1,575 per year.

If you are receiving social assistance benefits under Ontario Works (OW), Ontario Disability Support Program (OSDP), or Assistance to Children with Severe Disabilities (ACSD), you may be eligible to receive $1,050 annually per ostomy.

Residents of long-term care homes are eligible to receive $1,050 annually per ostomy.

For income tax purposes, you may be able to claim expenditures that exceed the amount of your grant.

The Ostomy Appliances Program is intended for persons insured under the Québec Health Insurance Plan who have undergone a permanent colostomy, ileostomy or urostomy. For each ostomy (surgical construction of an opening to allow for the discharge of urine or stools), the program provides for an amount of $700 to cover the costs of the ostomy appliances (bags and other products).

These new increases will total 62% more than in previous years!Got my notice letter about the ADP increase!

Special Benefits

There are special benefits for First Nations people and Inuit, which can be obtained through the Non-Insured Health Benefits program (NIHB). Information about that program can be found HERE.

Additionally, Veterans can receive up to 100% reimbursement after completing the appropriate forms. You can contact Veterans Affairs Canada for more information about medical supplies reimbursement HERE.

Tax Deductions

If you’ve paid out-of-pocket for any supplies, you could include them as a medical expense when filing for taxes. Please note that this doesn’t include products that have already been reimbursed by private insurance.

If you have private insurance, you can also claim the premiums when doing taxes.

Here’s information from the Canada Revenue Agency on how to submit medical expenses on your income tax forms:

Disability Tax Credit

This one is tricky, but some ostomates may qualify for disability tax credit, and it’s worth getting your doctor to sign the necessary forms to submit to Revenue Canada. If you have IBD that been difficult to manage, despite having an ostomy, the chances of being approved are even better.

Private Insurance

If you are lucky enough to have medical insurance through an employer, then you can take advantage of their services to help cover the cost of supplies. If you don’t already have coverage, private insurance is something that I’d highly recommend looking into.

Unfortunately, not all private insurance companies will accept you after you’ve had your surgery since it falls under a “pre-existing condition”, but there are still companies which who can offer coverage.

I’m with Green Shield Canada and for under $70, they currently cover $1500, $2500 and $5000 (1st, 2nd and 3rd+ year) worth of ostomy supplies and signed me up after my surgery.

Patient Assistance Programs

Some charities offer temporary financial assistance to patients who are unable to afford supplies.

Colon Cancer Canada offers up to $1500 in assistance (up to $500 for ostomy supplies) to qualified patients who have a colon cancer diagnosis through their Wendy Bear Patient Assistance Program.

Request Product Samples

One thing that I always recommend to ostomates, especially new ones, is to ask for product samples from various suppliers. In your first year as an ostomate, you’ll likely be trying new supplies until you find one that you love. These freebies can help delay out-of-pocket expenses for a few months!

Consider this a great time to use supplies before your grants or insurance kicks in, and be sure not to settle for something unless it works best for you!

TIP: if you subscribe to the Ostomy Canada magazine, you’ll often find advertisements for products that offer free samples.

In my product reviews, I often mention whether you can get samples for a particular product and where. My stoma nurse gave me a list of manufacturers to contact after leaving the hospital post-surgery. All the major brands like Coloplast, Hollister and ConvaTec will send you samples upon request, but there are many other companies who offer free samples.

You can find a list a list of manufacturers who offer free samples HERE.

Ebay/Kijiji/Craigslist

You’d be surprised at the gems you can find through these websites. I’ve been able to get free/low-cost supplies through Kijiji, but there are a few things to remember if you go this route:

Your insurance will likely not reimburse you for products purchased through these sites, so these will be out-of-pocket.

Sometimes the stuff you find are passed their expiry date; be sure to ask about the “freshness” of these products before you commit to anything.

Some of the stuff might be used. Liquids, powders, pastes, and sprays are often sold after being used a few times and are no longer needed; avoid these products unless it’s guaranteed that they haven’t been used.

Use caution when going to visit a stranger to pick up these supplies. If you can meet in a public place, that would be your safest bet.

Find Discount Suppliers

Your local medical supply store may not be the cheapest place to buy products from. I get most of my supplies online because of the low prices and quick delivery. You’d be surprised at how quickly $10-20 off a box of wafers or pouches can really add up!

TIP: Since most insurance companies won’t reimburse the cost of shipping, try to order enough to get free shipping when shopping online.

Some medical supply stores offer discounts to the members of local Ostomy Canada chapter members. You can usually find out which ones do through your local chapter’s newsletter. It’s always a good idea to find or ask about discounts before you place an order.

Temporary Help

If you are part of a local ostomy group, you might be able to connect with other members who have unused supplies they can give you for free or at a low price. This might not guarantee a steady flow of supplies, but it could help in situations where you might be in a pinch.

Practical Advice When Using Supplies.

While government assistance, being a savvy shopper and tax credits can help, there’s a lot of practical things you can do to help minimize your expenses.

Only use supplies that you need to. Are barrier rings really necessary for your situation? Do you really need to use barrier wipes? Are you able to get an extra day out of your wafer without compromising your skin’s health?

Consider using a one-piece appliance instead of two-piece systems, which tend to be more expensive. There are differences between the two systems, so THIS guide will come in handy.

If you don’t need a convex wafer, don’t use one! They are far more expensive than flat wafers!

Use certain products, like pouch deodorant, only during certain circumstances, like when going out in public.

Reuse your two-piece pouch. I’ve heard of many ostomates who rotate between two pouches and they clean their soiled one, and let it dry before using it again on the next appliance change. I’ve tried doing this a few times, but because I use filters on my pouches, this makes the filters useless, and I’ve had more leaks through the wafer coupling compared to when I use fresh pouches with each change.

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Andrea Ross

I go through an inordinate amount of supplies per month and cannot find any financial assistance other than Ontario ADP programme. This only covers about 2-3 months of supplies that I use in a year. I am a senior and have seniors group insurance through my previous employer, but they only cover 20% of the costs up to $3.000.00 per year, with a lifetime max of $50,000. There have been many times when I have had to go without an appliance due to financial restraints. Can you point me in a direction of financial assistance or is it best to go with additional coverage through green shield Canada? I do not want to sound whinny but am at my whits end and am certain that there are many people out there who suffer the same fate. I am not living, just existing due to costs and skin issues. Any guidance you can give me will be greatly appreciated.

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20 hours ago

Member

Joan

I am about to become an ostomate with an ileostomy. How much will it cost me each month for supplies? I think I will be going with a two piece system.

I’m grateful for any information. I haven’t seen an ET nurse yet, she was on vacation when I attended the pre admission clinic!

Depending on your appliance needs (i.e whether you need a flat or convex wafer; barrier ring; skin supplies, etc) your costs may vary wildly. If you only need a bag and pouch, it could cost under $100 a month, but if you need special supplies, then that amount could go up to $300+ and that’s assuming you aren’t changing your appliance more than once every three days.

Thank you for that Eric. Here’s hoping I’m lucky enough to keep to the lower budget. I live in Nova Scotia and I’m not eligible for any Government funding as I am not on benefits and my income is above their threshold. I have just printed off your dietary advice for the first six weeks and spent hours watching your videos to learn as much as possible before the event. Although feeling anxious about the surgery and recovery, I think I’m feeling pretty positive about life in general post surgery thanks in no small part to your very positive videos. Thank you. I’ll keep watching.

If you haven’t been looking for private insurance, I would suggest investigating now. I’ve been with Green Shield for many years, but the Ontario grants we get for supplies has gone up significantly, so the benefits of having insurance are diminishing. It’s still something that helped tremendously, especially at the beginning when I was going through more supplies than I am now.

Best of luck to you!

Reply

10 months ago

Member

Jeff W.

Hi Eric, Can I ask why a pouch that has a filter cannot be reused as you’ve mentioned above. Does it have to do with getting wet? Convatec sends extra filters with their pouches.

Some companies (like you mentioned, ConvaTec) have replaceable filters that can extend the life of the actual pouch. Most, unfortunately, come with a permanent filter that gets clogged quickly and cannot be replaced so the entire bag has to go.

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10 months ago

Member

Millie

As I search for information, your work keeps showing up. Thanks so much for the awesome work you do to help others. Greatly appreciated here!!

hehe, thanks! My goal is to eventually be the only place an ostomate needs to visit to get all the information they could ever need!

Reply

1 year ago

Member

Tom Johnson

It’s really good of you to do this for the Ostomy community. I recently had a major invoice fiasco with Canada Care Medical that caused me a lot of grief with my insurance company. Even though I get subsidized by insurance on top of the grant I negotiated a 10% permanent discount.

I see online that I can get the same products online at significantly lower prices (25-30% less). On my latest bill of $717 (that’s after the 10% off) I would have saved $200 buying from Payless.

The local markups are obscene. I’ll probably buy online from now on because I just can’t support that kind of price gouging.

I’ll add that it is also obscene that Holister has products that are plastic and adhesive, that I doubt cost more than 50c each to manufacture and they end up costing us $7-12 each. The Ceraring adapter at $6-9 each tops the scale of just wrong. It speaks to morally and ethically bankrupt American companies.

I am forever frustrated by the cost of supplies, especially the local prices, which seem to be 2-3x higher if you say you have insurance.

I have tried (and will review) some low-cost supplies, but you really can tell the difference in quality between premium brands and the low-cost ones (i.e thinner material, no filter, no fancy outlets, etc.).

Reply

1 year ago

Member

Stacy Bruce

Oops! Just sent you a private message earlier requesting a new post or update about insurance and tax deductions, and just now noticed that you have already done so in July 2017! The online suppliers are also excellent and I save at least 30-40$ per order! Thanks for all of this info Eric! It has saved me so much money and worries!

Thanks for your comment, Melissa. I’ve heard of them, but never ordered from them.

Reply

3 years ago

Member

Nldnrs

Individuals who served with the Canadian armed forces may be covered under the Department of Veteran Affairs for supplies. In addition, the federal Non-INsured Health Benefits program (NIHB) assists First Nation and Inuit but is based on a quota system. So individuals who may need more supplies may need to obtain further authorization from their doctor. Also, some insurance companies may partially reimburse the cost of a parastomal hernia belt.

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